Intra-Arterial Alteplase Thrombolysis during Mechanical Thrombectomy for Acute Ischemic Stroke

被引：42

作者：

Heiferman, Daniel M. ^{[1
]}

Li, Daphne D. ^{[1
]}

Pecoraro, Nathan C. ^{[1
]}

Smolenski, Angela M. ^{[2
]}

Tsimpas, Asterios ^{[2
]}

Ashley, William W., Jr. ^{[3
,4
]}

机构：

[1] Loyola Univ, Med Ctr, Stritch Sch Med, Dept Neurol Surg, Maywood, IL 60153 USA

[2] Advocate Illinois Masonic Med Ctr, Dept Neurol Surg, Chicago, IL USA

[3] Sinai Hosp, Sandra & Malcolm Berman Brain & Spine Inst, Dept Neurosurg, Baltimore, MD 21209 USA

[4] LifeBridge Hlth Syst, 5051 Greenspring Ave,Suite 300, Baltimore, MD 21209 USA

来源：

JOURNAL OF STROKE & CEREBROVASCULAR DISEASES | 2017年 / 26卷 / 12期

关键词：

Ischemic stroke; large-vessel occlusion; endovascular therapy; mechanical thrombectomy; tPA; alteplase; intra-arterial thrombolysis; stentriever; INTRAVENOUS T-PA; ENDOVASCULAR TREATMENT; TRIAL; THERAPY;

D O I：

10.1016/j.jstrokecerebrovasdis.2017.07.031

中图分类号：

Q189 [神经科学];

学科分类号：

071006 ;

摘要：

Background: Intra-arterial alteplase (IA tPA) is commonly used during mechanical thrombectomy for acute ischemic stroke in patients with large-vessel occlusion, but specific indications and applications for its use remain undefined. Methods: We analyzed 40 patients who underwent stent-retriever mechanical thrombectomy, 28 of whom received adjunctive IA tPA. To our knowledge, this is the largest cohort with this concomitant treatment reported in the literature in the post-mechanical thrombectomy trial era. Results: Between patients with and without IA tPA, rates of hemorrhagic conversion, neurologic outcome, and mortality were equivalent, with a trend toward improved angiographic revascularization observed in the IA tPA group. Conclusions: IA tPA is a safe adjunct to mechanical thrombectomy, and more investigation is warranted to understand ideal indications and dosage methodologies.

引用

页码：3004 / 3008

页数：5

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